Fall 2009 Speed School
Registration Form
Tuesday and Saturday November 3rd – November 24th 2009
Return form to The Next Level or
Fax: 240-497-1464 or
Email: robh@outdo-u.com
ATHLETE NAME____________________________________________
Address___________________________________________________
City/State/Zip_______________________________________________
Telephone___________________ EMAIL________________________
Total Paclage (7 sessions): $175 Per Session: $30 x (__)
Payment Method (Circle one) Credit card Check Cash
Card Number__________________________________Exp_________
Name on Card______________________________________________
Security Code _____________________________________________
Family Member or Friends: Would you like one (1) complimentary training session in one of our other athlete development training programs? Yes r No thanks r
(You can schedule at our front desk.)
Release of Liability:
I hereby waive and release for myself and my heirs, any and all rights or claims I may have against Next Level Athletic Performance Center, any school or facility in which Next Level Athletic Performance Center programs are conducted and each of their respective agents, employees, servants, officers, directors, and representatives, for injury or illness arising at the physical location of Next Level Athletic Performance Center in Bethesda, MD or a program site connected with my participation or my son/daughter’s participation in Next Level Athletic Performance Center programs. I further agree to identify and hold harmless of each said persons or property, which may arise by virtue of my participation or my child’s participation in Next Level Athletic Performance Center.
Responsible Party’s Signature____________________________________Date____________
(Parent Signature Required if Athlete is under 18)
